Posts Tagged ‘Alternative Medicine’

The October 27, 2009 edition of Wall Street Journal ran a story called “Metals: Panacea or Placebo?” by science reporter Melinda Beck that put a skeptical eye on claims of medical and health benefits to the use of metals (copper, silver, gold, titanium, and magnetic items) as adornments and “dietary ‘supplements.” The same week, a blog post by Steven Novella at Science-Based Medicine discussed the recently published “Therapeutic effects of magnetic and copper bracelets in osteoarthritis: A randomised placebo-controlled crossover trial” from Complementary Therapies in Medicine (abstract), which documented a controlled test on the efficacy of magnetic or copper bracelets to help arthritis and other ailments. Unsurprisingly, any benefits from the different bracelets were no better than placebo. Readers are referred to his excellent write-up for a discussion of the study and links to other peer-reviewed work. In it, the National Center for Complementary and Alternative Medicine, a dollar-sucking entity foisted on the taxpayers by Congress, admits that it has found no evidence for beneficial effects on fibromyalgia, migraines, or other painful conditions, from the use of metal bracelets. The idea of people volunteering to put large amounts of metal and metal solutions into their bodies intrigued me, so I reviewed the current state of Metal Medicine.

A couple years ago, Paul Karason became briefly famous as the “blue man” whose skin turned blue due to argyria — a condition where silver collects in the skin and organs and reacts with light, much as the silver emulsion on film. He dosed himself with silver solutions that he created in his home, a procedure easy for anyone who has taken a basic high school chemistry class. “I did it all on my own,” he said. “Originally, I just saw an ad for a colloidal silver generator in a magazine and the picture stuck in my head like a song might stick in your head. I had a friend who had severe petroleum poisoning, and I heard colloidal silver was helpful for that, and that’s how I started.” In the same interview, he admitted that his original health problem, dermatitis, was not cured by ingesting silver, although he continued to drink silver solutions daily. Proponents of colloidal silver claim that ingesting silver can cure or treat colds, flu, cancer, diabetes, herpes, shingles, and HIV/AIDS, among other ailments. Silver solutions, such as silver nitrate, have been used as anti-microbial disinfectants for many years, and frequently used as eyedrops for newborns to prevent conjunctivitis (although most former uses have been supplanted by newer, less toxic treatments). The FDA has repeatedly stated that ingesting silver is not beneficial, is not even safe, and can cause kidney damage.

Of course, one man’s woo is another man’s scam. A company called Purest Colloids charges that Karason was not using the correct silver (he’s ingesting silver in an ionic solution instead of pure silver in a colloid form), and that the stories about his condition are a hoax on the American people. From their web site:

The Blue Man charade demonstrates once again that the mass media cannot be trusted to report anything that even resembles a truthful “news” story. All “news” today is propagated with an agenda just like the phony economic statistics put out the U.S. government.

In other words, a conspiracy to make people afraid to take silver supplements. Oh, yeah.

Silver is not the oldest “magic metal.” Magnets have been tried as treatments for thousands of years. Randi has written extensively about the Q-ray and magnetic bracelets, and those scams continue to be perpetrated on the public with the usual blather about aligning one’s auras, improving the blood flow by acting on the iron in hemoglobin, and other wishful thinking. Dozens of websites sell these items, and while I do not wish to drive traffic to their sites, it’s interesting to poke around to see the prices, claims, and testimonials. “I thought I could save money,” says one alleged testimonial, “by buying another magnetic bracelet from another company advertising them at half the price with 5000 gauss. Well, let me tell you, I was scammed! When that ‘other’ bracelet came in, I checked the magnetic strength by seeing how strongly it attaches to a piece of metal compared to your bracelet…Thanks for a great product!” To view the going prices for lumps of metal, see for example Ace Magnetics or AACopper, which warns you again those cheap Chinese copper bracelets that don’t leave a green ring on your wrist. By doing a search of various magnet proponents, you’ll find you can now buy magnetic mattress pads, cushions, hair brushes — and even styling gel! I suspect if you spend $30 for magnetic hair spray, you are going to see some effects. (These items are ubiquitous on the internet, and a new company pops up every time one is shut down. For instance, in 2002, Quackwatch reported that the California Attorney General sued European Health Concepts for selling magnetic mattress pads and cushions. They’ve been out of business since then, but Googling ‘magnetic mattress pad’ turned up a dozen sites, selling pads running upwards of $800.)

Magnets are cheap to manufacture, but for a classy scam you need something more exotic. Gold has an ancient history as a nearly-magical elixir to provide immortality. For many years, gold salts were used to treat lupus and rheumatoid arthritis, although the toxicity of the metal caused mouth sores, kidney damage, and occasionally, problems with the bone marrow’s ability to make new blood cells (a side effect that killed one of my engineering professors). One supplier, Optimox, carries colloidal gold in tablet form. Although their site states “For use as a source of colloidal metallic gold without medical or health claims,” the subsequent copy clearly implies that colloidal gold can detoxify the liver, act as a anti-oxidant, control joint pain and swelling, and promote resistance to infection. (Since my 50 hours of college chemistry is nearly 30 years old, I won’t embarrass myself with a critique of all their claims about redox reactions, but invite knowledgeable readers to comment.) Another alarming claim, among many, is that taking 30 mg of gold per day for one month increases IQ scores by 20%. In rough terms, that means a month’s worth of tablets could take a person of average IQ into the top 5-10% of the population.

A more recent trend in metal therapies is titanium, which started in Japan. Generally, companies market titanium bracelets or pendants, claiming that the material enhances the flow of energy and creates a positive charge that cancels out pain’s negative charge — i.e., neutralizing the pain. To my knowledge, this particular benefit of titanium has not made it into the anesthesiologist’s tool bag. Some sites sell titanium items to relieve stress or back pain, and feature testimonials from professional athletes. One company, Rob Diamond, explains how the bracelet causes ions in the blood to push against vessel walls, causing heat, which improves circulation and carries away toxins. One of the biggest hawkers of titanium products is Phiten, founded by a chiropractor in Japan. This company has taken the snake oil to a new level, infusing titanium particles into lotions, clothing, shoes, and bedding. Testimonials from Olympic athletes and baseball players spread the word, enforcing the placebo effects of the items. They also market a product called “G Water” which they claim will suppress fatigue of the brain when you spray it on the head.

As the author of the WSJ article remarked “Perhaps if consumers became smarter, they would be more skeptical of such claims.”

According to the website for this product, a pen which represents a spine bent by chiropractic subluxations,

“the “Subluxated Pen” is a trusted and proven way to promote your practice. Your personalized information is imprinted on the bent part of the pen. The bend in the pen attracts attention in a unique, fun and powerful way. Using the Bent Pen is the inexpensive and professional method for building your patient community.”

The manufacturers of this promotional product tout the results of a 2008 study performed by ASI (Advertising Specialty Institute) which appear to show that Bent Pens are “the most effective and least expensive form of advertising.” I noticed some shady business when comparing the provided information on the website and the actual report from ASI. Most importantly, the report only mentions writing instruments. It does not specifically look into the effectiveness of Bent Pens themselves. That may not be a distinction that matters, but it could be that people don’t like novelty writing instruments with caps, instead preferring conventional click-top pens. It is unfair to make claims about a specific product based on the data. Despite this fact, the graph used by H.W. Industries on the Bent Pen website, which compares the cost per impression of Bent Pens (using the data based on writing instruments in general) with such advertising entities as magazine ads, prime time television spots and billboards, is made to look as if it came directly from the study. It did not. There is a section which lists the cost per impression of various types of advertising, however. In it, one can easily see that writing instruments, while cheap compared to national magazine ads for example, are no better than caps or bags in this regard.

In addition to the misleading graph, there is a section on the website which is cut and paste verbatim from the ASI study summary of conclusions. Well, almost verbatim. It curiously left out the part which revealed that of all the studied promotional products, wearable bags delivered the most impressions. The same wearable bags which had an equal cost per impression to writing instruments. Writing instruments provided only the fourth highest number of impressions per month. I guess Bent Bags are too difficult for even chiropractic technology to produce though. Of course a better form of advertising might be actually treating a legitimate medical problem.

To be entirely fair, H.W. Industries is not a chiropractic practice building company. They just seem to sell gimmicky crap, and they are apparantly no less concerned about twisting data to improve their profits than chiropractors are. But I probably shouldn’t be making fun of this at all considering I hand out fetus shaped keychain flashlights.

Faster than a speeding case report. More powerful than a double-blind, placebo-controlled study. Able to leap peer review in a single bound. Look! Up on the internet! It’s a story. It’s an anecdote. It’s a testimonial!

Every implausible and unproven quack therapy, from acupuncture to quantum healing, comes bearing testimonials of its effectiveness. These stories are typically brief, to the point, extremely powerful and, across the board, absolutely worthless. To anyone with a decent skeptical filter in place, the reliance on testimonials is an obvious sign of a complete lack of credible support for one’s claims. Yet to far too many people there is no introductory phrase more meaningful than “In my experience”. And no amount of published contradictory data or number of explanations from critically minded experts can match the effect from just one of the seemingly neverending supply of these uncontrolled, unblinded, and often tall, tales.

Sadly, even outright harm and suffering, or the complete lack of achieving the claimed benefit, are often unable to shake the faith of one who has stepped over the line that seperates credulity from a more critical approach to one’s health. It is far too easy to rationalize away these failures, placing the blame on themselves or the medical community, when the stranger whose gout was cured by taking goat urine supplements is trusted more than the family doctor. Perhaps the believer doesn’t realize that the near totality of the testimonials seen on television or on the internet are fabricated. Maybe they don’t realize that a significant number of them, as is often the case with fraudulent cancer cures, even when provided by real people are found to be the former words of the now deceased, victims of their disease process, their lack of critical thinking skills, and the bastards profiting off of them. It is more likely, however, that the undue influence of testimonials is hard-wired in the human brain, a remnant of something which at one point bestowed a survival advantage on our primitive ancestors.

There is a reason why quacks rely on testimonials. And that is because they don’t have science in their corner. Sure they will jump on poorly designed studies, usually coming out of the National Center for Complementary and Alternative Medicine and published in biased pseudojournals, and tout them as proof of their legitimacy. But they will just as quickly denigrate methodological naturalism and the methods of so-called “western science” when better studies come along revealing their pet delusion to be a charade. The testimonial circumvents this problem, rendering science irrelevant. This is a recipe for disaster, or at the very least a lighter wallet.

Proven treatments don’t need stories. In my line of work I often am faced with parents who refuse recommended practices such as vaccines and the administration of intramuscular vitamin K for newborns. When I am discussing the care of a child with parents, and presenting them with treatment options or evidence-based prophylaxis regimens, I don’t tell them about the time I used a particular treatment and how it cured the patient, or how I had this one kid who suffered a poor outcome because they didn’t get something I recommended. There are too many uncontrolled variables in most clinical situations to trust such anecdotes. I have to rely on good data, which should not consist of anecdotes regardless of how many I might collect over my career. I would be no better than the quacks I often rant about were I to attempt to manipulate parents with emotional testimonials.

A few days ago, my aunt sent me the name of a ‘nutritional supplement’ that her cousin had sold her sometime back. When she first told me about it, I pointed out that it sounded fishy. I did some research on the product, and found that it a product sold through a multi-level marketing company called “FirstFitness“. The website is more dedicated towards promoting new distributorships than its products, and like most MLMs, stresses how the participants can quit their stressful, high income jobs and work from home a few hours a week, and eventually win a Mercedes, dream vacations, and the like. Of course, you have to sign up 10 people, who each need to sign up 10 people…

She was persuaded to buy something called Lipomax 10, advertised as a homeopathic remedy to ‘support optimal liver function’ and ‘help relieve the symptoms of bloating, fatigue, water retention, allergies, sluggish bowels and a sluggish metabolism.’ That’s some powerful stuff!

The ingredients include ground dandelion seed, ground Celandine stem, milk thistle powder, and a ‘proprietary blend’ which is 99% turmeric extract, turmeric being a spice that gives mustard its characteristic yellow color and is a component of many curry powder blends.

For milk thistle, I did find that some research has been done, through the National Institute of Health, but through the National Center for Complementary and Alternative Medicines. If you’ve kept up with the news, you’ll remember that the sponsors of this center have been disappointed that the research has turned up no efficacy in anything they’ve studied to date. As far as milk thistle:

There have been some studies of milk thistle on liver disease in humans, but these have been small. Some promising data have been reported, but study results at this time are mixed.

Although some studies conducted outside the United States support claims of oral milk thistle to improve liver function, there have been flaws in study design and reporting. To date, there is no conclusive evidence to prove its claimed uses.

Recent NCCAM-funded research includes a phase II study to better understand the use of milk thistle for chronic hepatitis C. Additional research, cofunded by NCCAM and the National Institute of Diabetes and Digestive and Kidney Diseases, includes studies of milk thistle for chronic hepatitis C and nonalcoholic steatohepatitis (liver disease that occurs in people who drink little or no alcohol).

The National Cancer Institute and the National Institute of Nursing Research are also studying milk thistle, for cancer prevention and to treat complications in HIV patients.

In other words, nada.

My quick search of the dandelion and celandine showed even less promise – all the links were to natural or homeopathic sites, and talked about the wonders of these all-natural ingredients, and how they have been used ‘well known and used throughout Europe’ which apparently is meant to confer status. The sites claim that these herb promote health, aid digestion, improve liver function (apparently most of us are going around with non-functioning livers), prevent colds, inhibit tumor growth, improve appetite, cure yeast infections, and decrease glucose levels. Considering that my aunt is a diabetic, I’m not sure that taking dandelion capsules would be a good idea, if it really did change glucose levels in the blood willy-nilly.

I think my aunt was a bit embarrassed, and threw the stuff away. I suggested that she take the company’s money-back guarantee to heart and get her $35 back. She needn’t be embarrassed. I don’t know the cousin who sold her the stuff very well, but I recall that she is a bit incredulous about a great many things (she out one time belonged to a religious group who thought they could raise people from the dead), and was likely merely trying to supplement her income. The herbal, natural, and homeopathic supplements generate billions of dollars in sales each year, so there are a lot of well-intentioned, educated people who are uninformed about what is being sold, legally. Oprah is a big source of unsubstantiated garbage. For instance, she touts Acai berry, and sales increase dramatically. Wikipedia states:

Recently, the açai “berry” has been touted and marketed as a highly beneficial dietary supplement. Companies sell açaí berry products in the form of tablets, juice, smoothies, instant drink powders, and whole fruit.

As of March 2009, there are no controlled studies backing up any of these claims. According to ABC News correspondent Susan Donaldson, these products have not been evaluated (in the US) by the FDA, and their efficacy is questionable.[3] In late 2008, lawyers for The Oprah Winfrey Show began investigating alleged statements from supplement manufacturers who suggested that frequent Oprah guest Dr. Mehmet Oz had recommended their product or açai in general for weight loss.(Link)

The best we can do is to educate, gently, one person at a time. This morning, my mom sent me another one of those emails about how Swiffer cleaning solution kills pets, and added this note: ” thought I’d send it on just in case. please don’t google it and correct it, just delete.” She meant, don’t send her a link fromSnopes about how this is not true. I of course looked it up, and found that it not only wasn’t true and had numerous factual errors, the manufacturer of Swiffer, Proctor & Gamble, had issued press releases about the misinformation being circulated. Someone sent that link to my mom, someone who had probably received it via email on a list with hundreds of other email addresses in the chain, and some people would stop buying a perfectly safe product, and pass the email along yet again. I love my mom, and I’m not criticizing her, but she didn’t want to know the truth, and certainly didn’t want to respond back to the person who sent the email to her. And that is why bad information persists against the evidence.

Seattle, WA-Starbucks, the largest coffeehouse company in the world, announced earlier today that it would begin opening retail-based health care clinics in select locations as early as July.

According to Starbucks CEO Howard Schultz, the decision to expand into medical care was inspired by the growing popularity of clinics in supermarkets and pharmacies. “Folks are hurting out there, and retail-based clinics are a more economical option in many circumstances,” Schultz explains. “Starbucks will offer convenience and reasonable prices for the treatment of common medical concerns just like we do for whole bean organic Mexican shade grown medium roast coffee.”

But Schultz adds that Starbucks won’t be unveiling just another version of the CVS MinuteClinic or Walgreens Take Care Clinic. “There is a growing mistrust of mainstream medical establishments, regardless of whether they are located in a doctor’s office, a hospital, or a Walmart. And this won’t be one of them.”

Schultz points to a 2008 survey of health care consumers from the Center for Responsible Application of Pseudoscience (CRAP), a Seattle based think tank coincidentally located in the basement of a Starbucks. Advanced statistical analysis of the survey of nearly eleventy thousand adults revealed that almost 80% of responders would prefer that their medical care be provided by practitioners open to drawing from the world of alternative medicine for more natural treatment options. In response to epidemiological data like this, and the mounting evidence in CRAP approved peer-reviewed journals supporting the safety and efficacy of alternative therapies, Starbucks will staff its clinics with acupuncturists, chiropractors, and energy healers instead of the typical nurse practitioner. These operations will be supervised by naturopathic physicians.

The following gem was included in an Australian Broadcasting Corporation report on the recent identification by University of Minnesota researchers of specific spinothalamic tract neurons implicated in the sensation of itching and shut down by the act of scratching. The researchers, whose study is published as a Brief Communication in the April issue of Nature Neuroscience, express hope that now that this pathway has been discovered, it may eventually pave the way for treatments, pharmaceutical or involving electrical stimulation, that replicate the phenomenon and render scratching obsolete. For folks with certain conditions associated with chronic itching, which can be debilitating for some, this would be a welcome advance.

“Professor Marcello Costa, a neuroscientist at Adelaide’s Flinders University, says a pain treatment like acupuncture could be developed for itching.

“The acupuncture is not damaging, it’s a little bit invasive but it works very well because it activates much better than just rubbing,” Professor Costa said.

“So we all discovered rubbing by ourselves, just like we discovered scratching; we have a scientific rubbing which is called acupuncture but we don’t have a scientific scratching. So I expect this paper will generate interest in developing such a scientific scratcher.””

In the article, it is implied that Costa was one of the scientists or doctors in Australia excited by the team’s findings, and he appears to have no connection with the research. In reading the full text of the paper, I can find no mention of acupuncture so it would seem that Costa came completely out of left field with this comment, which makes not a lick of sense. How does one develop a new acupuncture treatment? Does a new acupuncture point, where there exists yet another mysterious blockage of “energy” as it courses along its equally enigmatic meridian, need to be discovered? One that impacts this specific spinothalamic tract pathway?

Clearly Costa already knows that acupuncture “works very well” for itching because it “activates much better than rubbing”. But activates what? Regardless, I’m sure we will soon be reading about a landmark study proving that acupuncture cures itching. It will involve a small number of unblinded subjects with no control group naturally but that won’t matter to the people that already know it works.

Making it as a chiropractor is hard. Some do very well, but because of low demand and marketplace oversaturation many practices fail. In fact, chiropractors are more likely to default on student loans than any other health related profession. It is easy to see why so many turn to the practice building techniques taught in chiropractic school classrooms and seminars run by companies promising to bring more patients in.

Virtually everything you see on a chiropractic website or read about a chiropractor in a local publication, is part of a prepackaged practice building scheme. The wording is carefully chosed to have the biggest impact. Every flyer or handout found in a chiropractor’s waiting room is designed to indoctrinate you so that you not only come back, but you go out and spread the word. Here is a nearly ubiquitous example from a chiropractic website’s FAQ section:

“How long will you need chiropractic care?

You’ll need chiropractic care as long as you live in Hanover Park and encounter physical, chemical or emotional stress that you cannot adapt to or accommodate. Ready to get started? Call our office today.”

And another from a different chiropractic website’s “Story of Chiropractic” page:

“Ultimately, the goal of the chiropractic treatment is to restore the body to its natural state of optimal health. In order to accomplish this, I use a variety of treatment methods, including manual adjustments, massage, trigger point therapy, nutrition, exercise rehabilitation, massage, as well as counseling on lifestyle issues that impact your health. Since the body has a remarkable ability to heal itself and to maintain its own health, the primary focus is simply to remove those things which interfere with the body’s normal healing ability.”

Usually these practice building techniques come in the form of setting up information booths at local gyms or fairs, ads for free spinal exams, or pseudojournalistic press releases run in smaller local publications or on personal websites (1, 2, 3, 4). I’m sure you have seen these before, but you may not have realized something.

These seemingly personal stories always revolve around two things. The chiropractor always tells the story of how he or she, or a family member, was injured and could only find relief in the caring hands of a chiropractor, thus inspiring them to join the field. And they always involve the chiropractor making a confession about how they have been taking the credit for healing all those patients when really it was the chiropractic all along. Check out the links above and you’ll see, and trust me there are thousands more that are easily accessible online.

The reason why the general format is similar, and often exactly the same word for word, is because these chiropractors are using a standard template bought from practice building firms. The chiropractor simply puts in his or her name, practice location and hours, and some personal information such as a picture and a description of his or her beautiful family. I imagine that they choose from a list of personal tragedies that led them into the chiropractors office, and the testimonials typically placed in the ad are likely invented as well.

Many of these ads disparage the medical profession, and I have come across a number which blame vaccines for SIDS and other health problems. I am constantly amazed at the audacity of placing these cookie cutter ads when the internet provides such an easy way to compare them to others and see through the charade. But I don’t think that anyone using such techniques ultimately care. It probably doesn’t take many suckers to fall for this tactic, and to sign a longterm maintenance contract, to turn a profit.